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Can J Hosp Pharm. 2010 May-Jun; 63(3): 250.
PMCID: PMC2901787

Non-medical Prescribing

Reviewed by Nese Yuksel, BScPharm, PharmD, ACPR, FCSHP, NCMP

M Sodha ,  S Dhillon , editors.  Pharmaceutical Press,  London, United Kingdom,  2009. Softcover,  240 pages. ISBN  978 0 85369 768 8.

This book is designed for nonmedical prescribers, including pharmacists, nurses, and optometrists. The book is intended as a guide for health care professionals who are interested in becoming supplementary or independent prescribers in the United Kingdom or as a resource for those who are already prescribers.

The book has 11 chapters divided into 2 sections. The first part of the book covers the key areas to consider for prescribing safely and effectively. The second part provides a brief overview of clinical topics that are of relevance for the nonmedical prescriber.

Key learning points are presented at the beginning of each chapter, which is a nice feature and helps to orient the reader to the chapter’s content. The chapters are nicely laid out, with subheadings appropriate to the content. Each of the clinical chapters is written by a practitioner in the area and provides clinical insights and reflections from prescribers, as well as case studies.

The first few chapters focus on the legal and ethical aspects of nonmedical prescribing in the United Kingdom, as well as clinical governance. Much detail is presented about the UK legislation, as well as the clinical governance framework established by the UK’s National Health Service for continuous quality improvement in health care. These first few chapters may have little relevance to pharmacists in Canada.

Chapter 4 provides an overview of the principles of prescribing and of designing dosage regimens. There is also a brief review of adverse drug reactions, drug interactions, and pharmacokinetic principles. These sections are not very comprehensive, and the reader will need to refer to other resources for more detailed information. Chapter 5 is the most useful chapter of the book and is relevant to a more global audience. It focuses on the principles of clinical decision-making and evidence-based prescribing. The chapter ends with some helpful hints on errors and pitfalls to avoid in prescribing.

Chapters 6 to 11 discuss prescribing for specific clinical topics: diabetes mellitus, cardiology, respiratory diseases, palliative care, oncology, and mental health. Each chapter begins with the principles of prescribing for that area, followed by a summary of the knowledge, competencies, and skills required for prescribing. Aspiring prescribers could use these lists as self-assessment checklists to identify their learning needs. Each chapter ends with a series of four or five case studies. Most of the case studies are structured in question-and-answer format, but this approach is not consistent for all chapters, nor is the same format of questioning used for all case studies. Readers may find this inconsistency frustrating. Furthermore, the case scenarios are specific to the United Kingdom and may use drug names that are not used in Canada.

Overall, the book is well written, easy to read, and not too technical, but it lacks the depth to be a comprehensive resource for the pharmacist prescriber. This book might be a starting point for learning about the principles of prescribing, but the reader will need to access other resources for a more comprehensive understanding. More importantly, this book is directed at practitioners in the United Kingdom and has limited applicability outside that jurisdiction. The book may be of interest to professional organizations and academics, especially as the prescribing regulations for various health care professionals continue to evolve in Canada. In this context, the book could be a helpful resource for information on the UK experience, as well as the important principles of safe and effective prescribing.

Articles from The Canadian Journal of Hospital Pharmacy are provided here courtesy of Canadian Society Of Hospital Pharmacists